Telehealth:Course Introduction and Telehealth Resources

By Jeffrey E. Barnett, Psy.D.

 

This is an introductory paper for the online course on telehealth. This is the first of fourteen papers that compose the course.

Telehealth, the use of technology to provide clinical services, is rapidly changing the face of the mental health professions. It is quickly entering the professional lives of most mental health professionals in its various forms.

Telehealth activities may include:

• Using the telephone for crisis intervention or other contacts between in-person sessions.
• Conducting telephone sessions with patients who are not able to attend in-person sessions for a period of time.
• Providing clinical services entirely by telephone to an individual in a different geographical area .
• Using email for in between in-person session contacts with clients.
• Using email to provide online counseling services with no in-person contact.
• Providing assessment or treatment services to an individual in a different location utilizing interactive televideo communications technology

As can be seen, telehealth, or e-health, may comprise a wide range of services provides utilizing a variety of technologies. The use of these services and technologies creates a number of tremendous opportunities as well as significant challenges. Individuals who would not otherwise receive treatment services may not have access to needed assessment and treatment as a result of telehealth. The homebound individual suffering from agoraphobia, the individual living in a remote area or lacking transportation to get to a professional’s office, and the individual uncomfortable with, or threatened by, in-person contact may all have access to needed mental health services thanks to telehealth. At the same time, the use of these technologies to provide clinical services brings with it a number of ethical, legal, and clinical challenges and dilemmas. Can standards of informed consent and maintaining confidentiality be maintained when utilizing telehealth? Does one need special training or competence to provide services via these media? Are there special licensure requirements one must address or is being licensed in one’s own jurisdiction sufficient? Are there other legal issues to attend to such as mandatory reporting requirements in the jurisdiction where the recipient of the services resides? Are counseling and psychotherapy services provided via the internet equivalent to in-person treatment services? Can crises adequately be managed even if the mental health professional is hundreds or thousands of miles from the client?

As can be seen, telehealth brings with it both great promise and significant challenges. But, with attention to the ethical, legal, and clinical issues addressed in this course, mental health professionals will develop an understanding of the issues we each need to address so we may provide telehealth services in an ethical, legal, and competent manner. Participants in this course will learn the ethics issues relevant to the provision of telehealth services to include informed consent, confidentiality, competence, documentation, emergency coverage, consultation, referral, and the role of professional standards and ethics codes; relevant legal issues to include licensure issues, understanding the role of other relevant laws in the jurisdiction where the services are being received, and liability issues; and relevant clinical issues to include determining if telehealth services are comparable to in-person assessment and treatment services, if they are appropriate for each potential client, and how to provide these services in a competent and effective manner.